多排螺旋CT平扫在儿童急诊食管异物中的诊断价值

MDCT in the Diagnosis and Management of Esophageal Foreign Body Clinical Value

目的 探讨多排螺旋CT平扫(MSCT)在儿童急诊食管异物中的诊断价值。方法 回顾性分析75例经食管镜或手术证实的食管异物患儿的临床资料及平扫多排螺旋CT(MSCT)图像特点。结果 75例术前平扫MSCT图像均诊断正确,诊断正确率100%。75例患儿的食管异物中,74例经食管镜顺利取出,1例经外科手术取出。异物种类繁多,其中禽畜骨26例、鱼骨21例,金属异物币12例,塑料制品6例,其他10例。异物形状:长条形54例,刺状、片状、团块状,圆形、不规则形等21例。异物的大小:7 mm~27 mm。异物嵌入方式:斜横两端嵌入食管57例,横行、斜行、纵行等18例。发生并发症26例(34.7%),其中9例发生食管穿孔,其他较轻微的并发症如食管黏膜糜烂、水肿、充血、溃疡、小出血等17例。X线平片检查11例,术前诊断正确8例(72.7%),3例漏诊。结论 平扫MSCT图像对儿童食管异物的检出率高,可清楚地显示异物的形态、大小、位置、食管损伤程度,有无并发症,以及异物与食管及周围组织结构的关系等,在临床诊断及指导后续治疗中具有重要的实用价值。

Objective To investigate the value of multi-slice spiral CT(MSCT) in the diagnosis and treatment of esophageal foreign bodies in children in emergency.Methods Preoperative MSCT images of 75 cases were diagnosed correctly,and the diagnostic accuracy was 100%.Of the 75 children with esophageal foreign bodies,74 were successfully removed by esophagoscopy,and 1 was surgically removed.Secondary complications occurred in 26 cases(34.7%),including esophageal perforation in 9 cases and other milder complications in 17 cases.11 cases were examined on radiographs,8 cases(72.7%) were correctly diagnosed preoperatively,and 3 cases were missed.Conclusions The detection rate of foreign bodies in the esophagus of children is high on MSCT scan,which can clearly show the morphology,size,location,degree of esophageal damage,the presence or absence of complications,as well as the relationship between the foreign body and the esophagus and the surrounding tissues and structures,which is of great value in the clinical diagnosis and treatment.